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Two-Year Follow-Up Study of One Hundred Two Cases

W. J. KAIPAINEN, M.D.; KARI SEPPALA, M.D.

AMA Arch Intern Med. 1957;100(3):419-422.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The literature on the treatment of endocarditis lenta recommends massive antibiotic therapy. Experience has proved that this is inevitable. However, the clinician has found it difficult to understand why the treatment of endocarditis lenta in particular calls for considerably higher penicillin doses than other diseases to destroy the microorganisms found sensitive to penicillin in vitro.

According to Moore (1946) the center of the vegetation is necrotic and relatively poor in cells; it is surrounded by bacterial colonies covered by fibrin and platelet masses. Studying the penetration of the fibrin clot by penicillin, Weinstein et al. (1951) found that it took two hours for the penicillin concentration inside the clot to equal that in the fluid outside. In addition, it was found that a viridans Streptococcus is capable of living in the fibrin clot in a penicillin concentration in which in other in vitro conditions it is easily destroyed. Hence it . . . [Full Text PDF of this Article]

Author Affiliations
Helsinki, Finland

From the Second Medical Clinic, University of Helsinki. Director: Prof. Ilmari Vartiainen, M.D.

Footnotes
Submitted for publication Nov. 5, 1956.

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